Introduction: Medication (Med) adherence is crucial for stroke prevention, but patients (pts) may have barriers such as inability to pay for prescriptions or limited med understanding. This can lead to inconsistent med adherence, recurrent strokes, readmissions, and negative outcomes. Evidence supports Medication to Beds (MTB), a predischarge med delivery program, as a possible solution to this problem. 1,3,5-7 Still, MTB program use in the stroke populations is limited. While MTB was offered at our hospital, it was not widely used by the Comprehensive Stroke Center (CSC). Our goal was to improve discharge teaching, optimize patient (pt) understanding of stroke meds and post-discharge (PD) outcomes. Methods: PDSA 3 and CQI 2 frameworks were used for this quality improvement (QI) project. The MTB intervention included revised CSC guidelines, PD summary instructions, pt education materials and bedside delivery of meds with education. CSC pts admitted to UF Health Shands between Jan. 1-Apr. 24, 2024 (pre-intervention) and Apr. 26, 2024-Mar. 31, 2025 (post-intervention) completed an identical PD survey assessing med comprehension (MC). The intervention was implemented on Apr. 25, 2024. Survey responses were scored on a 10-point scale with negative (1-8) or positive (9-10). CSC discharge Pt satisfaction was compared pre- to post-intervention. Chi-Square test was used for categorical variables and Mann-Whitney U test for continuous variables. Results: Our cohort consisted of 381 pts median age 67 (IQR: 58-77); 51.6% female. Of these, 94 were in the pre-intervention group; 287 were in the post-intervention group. Surveys were completed by 84 pts (22%). MC improved from 79.4% to 90%. Median hospital length of stay also decreased from 3.05 days (IQR: 2.03-5.08) to 2.49 days (IQR: 1.83-4.05, p=0.013). Discharge satisfaction improved from 88.9 to 91.1% with a corresponding increase in percentile ranking from 67 to 87. While our data was not powered enough to reach statistical significance in MC, these are positive results to validate effective QI. Conclusion: MTB program use contributed to improved pt understanding of stroke-specific meds, outcomes of care, and improved pt satisfaction. These findings support MTB program use to enhance med understanding in stroke populations. Future larger studies are needed to validate our results and to evaluate the intervention’s long-term impact on stroke prevention outcomes.
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Jeannette Hester
UF Health Shands Hospital
Mahmoud Fayed
University of Florida
Anders Magnuson
General / Preventive / Lipids
Stroke
University of Florida
University of Florida Health
UF Health Shands Hospital
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Hester et al. (Thu,) studied this question.
synapsesocial.com/papers/6980fd18c1c9540dea80ed0d — DOI: https://doi.org/10.1161/str.57.suppl_1.tp212